Recurrent Miscarriage – What To Do Next?

Firstly if you are reading this post having found yourself  in the ‘recurrent miscarriage’ bracket, then I am sorry. I am sorry that you have suffered repeated pregnancy loss and I hope that you are okay. If you have stumbled cross this little corner of the internet I hope you find some of my words useful.. I thought I’d write this little blog post with some advice for you, based on what I did once I found out about my third miscarriage

DISCLAIMER: MOST OF THIS INFORMATION IS BASED ON MY PERSONAL EXPERIENCE AS A PERSON LIVING IN THE ENGLAND. I UNDERSTAND GUIDANCE AND REFERRAL PRACTICES MAY VARY ACROSS THE WORLD.

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1 – GET REFERRED TO A SPECIALIST RECURRENT MISCARRIAGE CLINIC

I’ve put this step first as often it can be a relatively lengthy process and I found it extremely helpful knowing that I had got the ball rolling, as it were.

Go along to your GP/family doctor and let them know what has happened. They should be empathetic and enquire about the nature of your losses. Sometimes, particularly if you have been seen in the Early Pregnancy Unit, they may have this information on your notes already – but this is not always the case, so you may need to relive some of your painful experiences again. If it helps, go with someone – your partner, mum, sister whomever you think will be helpful in this situation.

Be aware of the referral criteria for recurrent miscarriage clinics (RMC). In England where I live and work as a GP, the guidance is clear and simple:

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Don’t let any healthcare professional tell you that early losses ‘do not count’. They  f*£@$g do!

2 – SEEK PROFESSIONAL SUPPORT

This is where your looking after your mental health becomes paramount, if it previously has not been a priority that is. I know I became heavily focused on trying to have a baby and at times, feeling very negative about myself and at my body’s inability to carry a baby. There is a risk of starting to self-loathe excessively and these thoughts may develop into depression where you persistently feel unhappiness, hopelessness, tearful and  lose interest in things you once enjoyed. If these symptoms ring a bell please seek medical advice – speak to your doctor who can help you navigate your feelings and offer you for the right kind of support.

I fact it may be useful to seek professional support anyway. In a previous blog post I spoke about how I sought support via the Early Pregnancy Unit and saw a specialist bereavement counsellor, trained specifically at helping women through early pregnancy loss. If this service is available locally to you, utilise it!!

Other professional support may be from some of the numerous charities and organisations that are helping support women and couples through pregnancy loss. For example:

3 – SELF-CARE

We all should be doing this all the time right? But the reality is that some times we neglect ourselves a little bit during this whole TTC thing… You know when people say to ‘just relax’ well, I wonder if self-care is what they actually mean.

Self-care is totally ‘on trend’ at the moment, but what does it actually mean? It can be defined as the practice of taking an active role in protecting one’s own wellbeing and happiness, in particular during periods of stress¹.

So it means you need to be active in doing something to maintain your own wellbeing…

I found ways to do this by practising mindfulness, acupuncture and seeing friends and family (click for previous blog posts ). Others may find yoga, running, baking, walking, reading or whatever helps… Just do whatever you enjoy doing to proactively help to to protect your physical and mental wellbeing.

4 – FIND YOUR COMMUNITY

You are not alone in going through pregnancy loss.

Initially I felt very alone. I was unsure who to speak to as it appeared no one else I knew had experienced the pain of miscarriage. I turned to the internet to try to find some support and I was introduce to a huge online commnity of (mainly) women sharing their experiences. This was initially on forums on websites such as Babycentre, but now I have discovered more ways to find the babyloss community – there are blogs, Instagram pages, Twitter…

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As you may already now, I now co-host a Podcast called ‘M’s The Word’ where we aim to break the stigma surrounding baby loss by simply sharing our stories and other people’s experiences. Have a listen using your favourite Podcast app or click here.

5 – READ THE RCOG GUIDELINES

rmc-guidelines.jpgThe current guidelines were published in 2011 (which to me seems like quite a while ago and I cannot see when the next review date is supposed to be) and can be found here.

Although they are clinical guidelines, published to help clinicians with the investigation and management of women/couples who have had recurrent first trimester miscarriage or who have suffered second trimester loss, I also feel they are essential reading for any woman/couple who find themselves in this situation.

Remember, knowledge is power… If you know what is recommended it will help you:

  • A – prepare for what you might expect in terms of investigation (bloods, ultrasound etc)
  • B – understand what may not be offered on the NHS and the rationale behind this
  • C – ensure you are receiving the best care

The guidance covers in some detail some of the known risk factors for RPL and the recommended investigations and some treatment options are discussed.

To me, it seems quite limited in terms of the recommended treatment and as it is now eight years old, does not include some of the recent research. BUT it appears to be the document that some clinics stick to.

In hindsight, I wish that I had treated this guideline as an initial screening  tool and once my first set of tests from my local hospital came back normal, I should have requested referral to a SPECIALIST RECURRENT MISCARRIAGE CLINIC  e.g. a National Tommy’s Clinic/Research Centre (but instead we went back to TTC and I suffered my 4th pregnancy loss).

Still, I would strongly recommend that you read these guidelines so you know what to expect.

And that’s it!

Once again I am sorry that you are here, in this situation, and I hope that my tips go some way to helping you right now.

Big love!

Xx

 

1  Oxford Dictionaries | English. (2019). self-care | Definition of self-care in English by Oxford Dictionaries. [online] Available at: https://en.oxforddictionaries.com/definition/self-care [Accessed 17 May 2019].

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